What is dry needling?

Dry needling is a minimally invasive intervention that uses a thin needle of varying lengths, depending on the tissue that is being treated. For example, bigger muscles sometimes call for longer needles. Dry needling is used to target soft tissue such as muscles, tendons, and fascia. It is called "dry" needling because nothing is injected into the body via the needle.

Depending on the targeted tissue and what is appropriate for each client, dry needling is usually a quick technique that takes minutes. It can be an in-and-out technique or left in for a few minutes.

This depends on the area and specific soft tissue that is being treated. Physical therapists in the United States began using dry needling in the 1980s. It has become a more popular intervention in recent years for physical therapists.

Dry needling can also be practiced by athletic trainers, for example. Guidelines and restrictions surrounding dry needling and who can practice it are usually determined by the state.

Dry needling and acupuncture share some similarities, such as the use of a thin needle. 

However, they have different goals, histories, and methods. Acupuncture has been around for thousands of years and is also practiced around the world. Dry needling is not as widely practiced. Acupuncture can address more systemic problems and targets more than just musculoskeletal pain.

Energy flow or meridians can be a common target for acupuncture. However, they can also target muscles like dry needling does. The needle placement is not always specific to a painful area like it is in dry needling. Dry needling is more direct to the painful area and primarily targets the musculoskeletal system, specifically soft tissue dysfunction.

How does dry needling work?

The main goal of dry needling is to target a trigger point and initiate a healing response at a physiological level. A trigger point can be defined as an irritable point in a muscle that is associated with an irritated and palpable nodule in a taut band of muscle. When a trigger point is palpated, it frequently refers pain elsewhere.

This is defined as a latent trigger point. Without being palpated, trigger points can also refer pain elsewhere. These are called active trigger points and are usually common pain generators. These are usually located in the belly of a muscle. Active trigger points can sometimes become latent trigger points. When dry needling is used on a trigger point, it can create a twitch response. This is an involuntary contraction or twitch of the muscle.

In theory, this releases the taut bands and muscular tension. In addition, inserting a needle into soft tissue can cause microtrauma. This can activate the body’s normal immune response to initiate a healing response. Also, this is similar to the body’s physiological response to a paper cut, for example.

What is dry needling used for?

Dry needling is best for soft tissue dysfunction. The target tissue of dry needling is usually inserted directly into a trigger point of a muscle or the peripheral soft tissue of the painful area and/or pain generator. It can be used for low back pain if appropriate. This is my personal favorite treat. Additionally, it can also be appropriate for neck, shoulder, hip, thigh, heel, and lower leg pain.

What are the risks and contraindications of dry needling?

Dry needling can be uncomfortable or painful during the process. You may notice some tightness, aching, or twitching while the needle is inserted into the soft tissue. Soreness can occur and may last a few days. Common side effects include bruising, bleeding, muscle soreness, drowsiness, and fatigue.

Depending on the case, dry needling can sometimes provide (usually temporary) relief after one visit. However, there is not a set number of visits it takes to provide relief. It is meant to be used in conjunction with other interventions such as manual therapy and exercise. The success of the intervention depends on the case.

Dry needling is not for anyone who has a fear of needles, is uncomfortable with, or is unsure about the intervention.

It is also inappropriate for those who are immunocompromised, have blood diseases, or are on blood thinners. It is also contraindicated for those with cancer, fresh scar tissue, sutures, infection, non-controlled diabetes, autoimmune diseases, breast implants, pacemakers, bone stimulators, spine stimulators, pregnancy, seizure disorders, or prior to 12 weeks post-op.

Pneumothorax is the most serious risk that comes with dry needling. This is an unintentional puncture of the lung. This would require medical treatment. Shortness of breath, for example, can last for days or weeks. A more severe lung puncture may require hospitalization.

However, this is rare. Risks may include infection, bruising, or nerve injury. Bruising is a common occurrence and should not be a cause for concern. The needles are notably small and do not have a cutting edge. The occurrence of any significant tissue trauma from dry needling is not common. I avoid needling certain areas such as the anterior neck, trunk, and midback for safety reasons.

Avoiding pneumothorax is one of the reasons I avoid the thoracic spine and lung field areas. This is done to avoid arteries, nerves, and organs. It is usually not an intervention that is appropriate to use in every therapy session. I also prefer to use more conservative measures such as exercise and manual therapy.

These methods are less aggressive and easier to use to help you manage your symptoms independently. 

Areas that are needled and methods that are used vary across providers due to where they completed their training and how they were taught specifically. After your provider has completed a physical evaluation and assessment, dry needling is most appropriate.

This is important to rule out any red flags and determine if the client is appropriate for the intervention. If you fit the criteria and have not been able to fully relieve your pain with other methods, you may have success giving dry needling a try.

Dry Needling at CORE Therapy & Pilates in Westlake Hills.

More information on dry needling can be found at here. 

Thanks for reading, and please call 512.215.4227 for dry needling in Austin.